Minister Gives Dental Masterclass

Minister Gives Dental Masterclass

By the standards of a Parliamentary Under-Secretary of State for Health and Social Care, Dame Andrea Leadsom is a big beast. 

This is the parliamentarian who had concluded that she was was the best available Prime Ministerial material, when she ran for the Leadership of her party. Now, NHS dentistry is part of her portfolio, and this week she has been answering oral questions in the Commons about Accessibility to Dental Services. It would be a good time, if not to reveal, then at least trail, the long promised recovery plan, or any further contractual changes.

Questions began with a trio of MPs representing Labour, the Conservatives, and the Lib Dems, all asking questions about access and capacity. Layla Moran (Oxford West and Abingdon LD) enquired about access to urgent care and oral surgery. Giles Watling (Clacton Con) had a simple request: “What recent steps she has taken to increase capacity in NHS dental care.” Frequent dental enquirer, Rachael Maskell (York Central Lab/Co-op) wanted to know what progress had been made with the dental recovery plan.

It is worth reproducing Andrea Leadsom’s reply in full: “I am determined to ensure that everybody who needs NHS dental care can receive it. We have already implemented a package of reforms to improve access and provide fairer remuneration for dentists. That has had an effect, with 1.7 million more adults being seen, 800,000 more children being seen and a 23% increase in NHS activity in the past year. We know we need to do much more, and our dentistry recovery plan will be published shortly, setting out a big package of change.”

Readers will see that apart from covering many of the numbers on the NHS government spokespersons’ NHS dental bingo card, there was nothing new, and as expected, some of the figures are deceptive. That will not surprise GDPUK readers, and the three MPs were ready to try again.

Layla Moran said that the Ministers claimed changes had not come to Oxfordshire. She spoke of a constituent whose previous NHS practice had closed, then phoned 12 practices that supposedly offered NHS care. All could only offer private treatment when he called. A consequence was demand being shifted out of practices, and into A&E.

Responding, Dame Andrea was “incredibly sympathetic.” However, according to the local ICB in the 24 months to June 2023 the number of adults seen on the NHS had risen from 448,000 to 485,000, as well as a similar percentage for children. “The situation is improving, but I completely agree with her that we need to do more, and we will be coming forward shortly with a big package of dental recovery plan reforms,” she concluded.

Giles Watling’s follow up was to ask if she could she could, “confirm that NHS England locally has finally been unblocked and that my constituents in Clacton will soon benefit from more dentists practising on NHS patients?”

The minister intriguingly replied that it was for the ICB to determine whether it wished “to support the excellent pilot proposal for overseas dental students in Clacton. At the same time, it needs to ensure that its actions are compliant with current legislation and within the delegation agreement with NHS England.”

Rachael Maskell took a more direct line in her response to the Minister’s earlier pro forma reply. “We were promised “before the summer”, we were promised “after the summer”, we were promised “before Christmas”, we were promised “soon” and now we have been promised “shortly”. The reality is that Labour has a plan and the Government have not. In York, we cannot get an NHS dentist either. Blossom Family Dental Care is just handing back its contract. My constituents have nowhere to go. What is the Minister going to do to ensure that my constituents can access NHS dentistry?”

The Ministers reply also showed a change in tone, beginning by referencing Covid and her plans for reforms, but then contrasted them to Labour’s “paper ambitions,” and suggested she talk to her ICB, who are one of the ring fence offenders.

Paul Bristow (Peterborough Con) then asked about his local situation where a medical centre seeking to open a dental practice would need flexibility in UDA rates and the ability to recruit dentists from overseas.

This was the sort of question the Minister could work with. Her hon. Friend was “pushing against an open door”. She spoke about the 2023 legislative changes to give the General Dental Council more flexibility to expand the registration options open to international dentists, and appeared to claim responsibility for, “tripling the capacity” at sittings of the overseas registration exam. She would also be bringing forward measures to enable dental therapists to work “at the top of their training,” to “expand the capacity.” With possibly something new to add she finished by saying, “He is right that reform of the UDA is also required and we will be bringing forward our plans shortly.”

Shadow Minister Preet Kaur Gill (Birmingham, Edgbaston Lab/Co-op) then quoted Emma from Grimsby, who had said, “NHS dentistry is a joke in the town at the moment. Thankfully I managed to get an emergency appointment in Scunthorpe (after being offered one in Doncaster originally) and I’ve now been referred to hospital to have 3 wisdom teeth removed. My dentist closed at the onset of the pandemic and I’ve not been able to register with an NHS dentist since.” He asked what the Minister had to say to Emma.

Emma, it turned out, had the Ministers, “Absolute sympathy.” She could however tell her that in July 2022 there had been “significant reforms.” There was also the long-term workforce plan and overseas registration, plus changes to dental therapists programmes, all of which would improve the situation. In the meantime the recovery plan would be bought forward “very soon.” Tantalisingly this would, “immediately expand the incentives to NHS dentists.”


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